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Anaemia - Upping the energy level

Upping the energy level

Your two-year-old has just spent the morning drifting from sofa to chair and back again with hardly enough energy to lift his head. He picks up a toy, lets it fall, picks up a book, lets it fall, then lets himself fall--bottom-first, thank heavens--to the floor. Now he sits on the rug looking up at you in mute appeal. He's thoroughly exhausted--even though he's had a full night's sleep.

Healthy children--particularly healthy two-year-old children--bounce through life like Super Balls. They do not stop unless it's to attack the cat, clear the bookshelf or throw pots and pans on the floor. So when any child slows to a walk--particularly a listless, lethargic, blankie-dragging-behind kind of walk-it's time to check with your child's doctor.

Sometimes the problem is iron -deficiency anemia, says Fergus Clydesdale, ph.D., head of the Department of Food Science at the University of Massachusetts--Amherst. It's especially likely if your child is experiencing the growth spurt that occurs between the ages of 9 and 18 months or, in girls, around the age when menstruation begins. Children of those ages may frequently demand more iron than they get in a normal, balanced diet.

The National Research Council reports that children need anywhere between 6 and 12 milligrams of iron every day to build the red blood cells that will carry food and oxygen to hard-working organs throughout the body. So if you suspect your child is not getting even the Recommended Dietary Allowance of iron , here are a few tips to boost his intake and help battle anemia.

Use C as a mixer. ''Increase your child's vitamin C intake when she's eating something rich in iron and she'll absorb more of the iron ,'' suggests Lisa Licavoli, R.D., a dietitian in Newport Beach, California. Broccoli, green peppers and citrus fruits are good sources of vitamin C .

Strive for variety. Other iron-rich foods include pinto or kidney beans, almonds, enriched cereals and enriched whole-grain breads, says Licavoli. Beans are not usually the favorite of most kids--but you can include them in soups and salads, suggests Dr. Clydesdale. And make whole-grain breads the standard in your household.

When to See the Doctor

''If your child is pale, lethargic and listless, it's time to see a doctor,'' says paul M. Fleiss, M.D., a pediatrician, lecturer at the University of California, Los Angeles, School of public Health and assistant clinical professor of pediatrics at the University of Southern California School of Medicine. Although these symptoms in children are possibly signs of irondeficiency anemia, other causes need to be ruled out.

In very rare cases, children may be suffering from blood loss or other blood problems that would affect their behavior. So be sure to check with a doctor before assuming that your child just needs more iron.

Toss that Teflon. '' When you use a cast-iron skillet instead of a Tefloncoated or aluminum one, you increase the iron content of foods, particularly when you cook acidic foods like tomato sauce,'' says Licavoli.

Snack and grow. ''Give your kids dried fruit,'' Licavoli adds. '' When you dehydrate fruit and get rid of the water, it concentrates nutrients like iron . Children especially like apricots, figs and raisins''--all of which are rich in iron . Note: Dried fruit is sweet and sticky and may cause dental problems if kids don't brush their teeth after eating it, according to Dr. Clydesdale.

Hold the tea. If your child loves iced tea, be aware that the tannic acid in tea hinders iron absorption, says Gregory Landry, M.D., staff pediatrician at the University of Wisconsin Sports Medicine Clinic in Madison and associate professor in the Department of pediatrics at the University of Wisconsin-Madison Medical School. A glass once in a while isn't going to hurt. But Dr. Landry says you shouldn't let children substitute iced tea for water on a hot summer day. In addition to interfering with iron absorption, several glasses of tea provide a large amount of caffeine for a child.

Breastfeed. To help prevent iron -deficiency anemia in infants, all doctors should recommend breastfeeding, according to Los Angeles pediatrician paul M. Fleiss, M.D., a pediatrician, lecturer at the University of California, Los Angeles, School of public Health and assistant clinical professor of pediatrics at the University of Southern California School of Medicine. ''Breast milk supplies almost all the nutrients your baby needs,'' he says.

Teach. ''Give your children nutrition lessons, especially when your daughters begin to menstruate,'' suggests Dr. Landry. Help them identify various iron -rich foods as ''good,'' ''better'' and ''best'' choices. Occasional praise when they select iron -rich foods may also be helpful.

Skip the supplements. You might assume that extra iron in supplement form is a cost-effective way to prevent anemia. Not so, according to Dr. Landry. '' Vitamin supplements with iron are a waste of money for most children,'' he says. Unless the doctor specifically recommends supplements for your child, they are usually unnecessary, he says.

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